Provider Demographics
NPI:1861467425
Name:BUCHHOLTZ, MICHAEL SETH (MD FACP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SETH
Last Name:BUCHHOLTZ
Suffix:
Gender:M
Credentials:MD FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:270 PULASKI RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-1601
Mailing Address - Country:US
Mailing Address - Phone:631-427-6060
Mailing Address - Fax:631-549-4858
Practice Address - Street 1:789 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3912
Practice Address - Country:US
Practice Address - Phone:631-425-2280
Practice Address - Fax:631-549-4858
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2021-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY166089207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01568890Medicaid
E17225Medicare UPIN
NY01568890Medicaid
4345870001Medicare NSC